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Weakness and strength of germany healthcare system
The german healthcare system in comparison to the united states healthcare system
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Jürgen, a legal resident of Germany, has recently suffered a stroke and must utilize his country’s healthcare system. Since he is a legal resident of Germany, he will have access to insurance through various not-for-profit health insurance funds called “sickness funds” (Blümel and Busse 2014). Through the Statutory Health Insurance (SHI) scheme, these not-for-profit organizations all must guarantee issue. This means that Jürgen will have access to an insurance program regardless of his medical background; he will also have the opportunity to choose between different available plans. These plans are available to Jürgen regardless of his age and geographic location in Germany. These plans are also available to Jürgen regardless of his income. …show more content…
In Germany, the health insurance system includes both public-sector and private-sector insurance companies. The public-sector insurance groups are part of the SHI system and include more than a hundred sickness funds (Blümel and Busse 63). For sickness funds, individuals and their employer split the mandatory contributions, individuals contributing 8.2 percent of their income and employers paying another 7.3 percent (Blümel and Busse 64). These monthly contributions are capped at €630 (or 804 US dollars), which encompasses both employee and employer contributions. These required contributions apply to pensioners and their pension funds, respectively (Blümel and Busse 64). In this way, people pay depending on their income, not based on their health status. If Jürgen is low-income, he would pay less money per month than if he were high-income. Anyone covered under SHI also can rest assured that coverage is extended to dependents as well, which includes children and unemployed spouses. Through general taxes, the federal government of Germany funds certain SHI perks such as free coverage for children. (Blümel and Busse 64). Since SHI sickness funds are all nonprofit, depending on whether revenues are too low or high, individuals may be charged an additional premium or paid an annual bonus. In 2014, none of the sickness funds had to charge extra premiums, and around twenty even paid bonuses upwards of €263 (or …show more content…
Most of the population, about 86 percent, receive coverage through nonprofit sickness funds within the statutory health insurance (SHI) scheme, while about 11 percent are covered through substitutive private health insurance (PHI). The remainder of the population are covered via special programs (Blümel and Busse 63).
Due to guaranteed issue in Germany, Jürgen, or any citizen, will not be denied healthcare coverage because of a particular illness. In addition, no citizen will be denied coverage because of a pre-existing condition either. The same standard applies to all citizens, regardless of age or wealth. In fact, although the German government does not directly finance or provide health care, it watches the country’s nonprofits and for-profits very closely to make sure that they do not increase any patient’s insurance rates or stop providing coverage as the patients grow older or sicker
In the 1800’s, the Netherlands, Sweden, and Belgium, among others, began to establish “socialized insurance policies” and medical care, which are still in effect today, while at the same time, the United States began to furthe...
In comparison, Germany spent slightly more than 11% of GDP (2011) towards healthcare funding. Universal health insurance is available to everybody with an option to purchase private insurance coverage (The U.S. Health Care System: An International Perspective, 2014). Approximately 90% of the population uses the national system in which premiums are income based. The system uses 240 private insurers for a non-profit, competitive system. Insurance costs are significantly less than the U.S. due to cost negotiations for medical facilities, appointments, and prescription medications (Sick Around the World, 2008).
During the economic growth that erupted during the World War II era, Congress passed the Revenue Act of 1942 as a direct attempt to combat excessive wartime profiteering by companies. In “One Nation, Uninsured”, Jill Quadagno revealed that an unexpected side effect of this law swiftly arose when employers decided to provide health benefits to their workers as a way to reduce paying the mandated government taxes on excess profits. By providing these benefits, many companies in the industrial sector were able to recruit new workers who were willing to accept slightly reduced wages in exchange for receiving tax-deductible benefit plans, along with satisfy the demands by trade unions to include fringe benefits in employment contracts. The symbiotic relationship that resulted when employers took on the burden of purchasing health insurance plans for their employees became the foundation for the American employer-based health insurance system which is still being used today.
Secondly, health insurance policies are inconsistent, expensive, cumbersome, hard to discern, full of fine print and contain many loopholes. Most Canadians face a huge tax burden, rising cost of living and will not be able to pay for these additional medical expenses out of the pocket. To offload risk, most indiv...
Health insurance is currently an important issue in the United States. Everyday more and more Americans become uninsured due to job loss and an increase in premiums. These Americans add to the ever growing population of 45.7 million people who are currently uninsured (Bialik). Moreover only 27% of those uninsured are under the age of 65 (NCHC). This is staggering considering most of those who are uninsured have, or soon will, suffer from some sort of illness or injury. As a result they will not be able to afford proper treatment. Insurance premiums can range in cost from fifty dollars per month, to fifteen hundred dollars per month (Kreidler). An individual’s premium is determined by factors they choose as well as other factors looked at by their provider. The cost of health insurance in America varies depending on the controllable factors, like particular insurance policies, and uncontrollable factors, like age.
The three main types of health insurance in the United States are voluntary, social and welfare. These types on insurance a person possess sometimes determine the ability to seek care and how that care is given. Insurance types such as voluntary and social insurance can be very expensive and will make participants consider how important it is for them to see the doctor, while welfare medicine participants have trouble finding a doctor due to the limit number of physicians who are provider or are refusing to take on new patients. Some of the types of voluntary insurance are Blue Cross and Blue Shield (BCBS), private and commercial insurance, and health maintenance organizations. Voluntary insurance is not only limited to health care from physicians, but can also include dental, long-term, and life insurance. One of the most popular voluntary insurance companies is BCBS. Sometime people have trouble paying for insurance especially if is as it related to an on the job injury or because they have reached retirement age and can no longer work.
Patel, Kavita. “Helping Consumers Understand and Use Health Insurance in 2014” Institute of Medicine. Institute of Medicine. 29 May. 2013. Web. 31 Jan. 2014. .
The cost of insurance has increased dramatically over the past decade, far surpassing the general rate of inflation in most years. Between 1989 and 1996, the average amount an employee had to contribute for family coverage jumped from $935 to $1778. In 1990, American companies spent $177 billion on health benefits for workers and their dependents; that number rose to $252 billion by 1996, or more than double the rate of inflation. Among the cost drivers: an aging population – the number of senior citizens who need health benefits is increasing dramatically every year; medical technology advances – which decreased the death rate; new drugs – expensive and effective, which make us live longer; and of course the increase of fear in medical litigations among doctors. Increase in usage will surely increase the cost of health care. On average, between the ages of 45 and 65, a person’s usage of health care triples. Eighty year-olds use nine times more health care services than 45 year-olds. By the year 2030, the number of people over 65 is expected to double. The cost for medical services have increased as well. Since 1980, medical cost have risen 281%. The number of organ transplants has doubled in the past 15 years, and all transplants cost over $100,000.
Although it is understood there are some benefits to having healthcare, like having access to health care they may not have had before, there were no regulations put in place on insurance companies. When people began being forced to have insurance, the insurance company’s raised their premiums, making it harder to afford. Individuals started seeing higher out of pocket expenses because of higher deductibles and copays, before the insurance plan pays anything. So the average citizen may over the course of a year pay thousands of dollars to their insurance between premiums and deductibles and never see the full benefit’s the police has to offer.
“47 million U.S. residents have no health insurance, and the numbers keep growing. America’s workers struggle to pay higher premiums, deductibles and co-payments. Working families are experiencing increases in the costs of health insurance, more out-of-pocket costs for doctor visits and skyrocketing prices for prescriptions, forcing many to delay getting needed medical care or words“(2012). The video Sick Around America introduced many issues with the United States health care system. The biggest problems in the United States is medical underwriting, if you lose your job that provides health insurance, you lose the health insurance.
The United States passed bill that health insurance should be mandatory in the year 2014. Under the Patient Protection Affordable Care Act, each person is required to have at least a minimum level of health insurance failure to, the individual will face a penalty. The mandatory health insurance issue has faced reactions from both sides with some people supporting while others opposing. It is mandatory for every individual to purchase a health insurance depending on their earnings. The health care insurance is mandatory for all US citizens, and all legal residents in America. It is considered as an individual responsibility requirement, and those without this insurance are subject to a tax penalty of $750 per year up to a maximum of three times that amount ($2,250) per family. However, there are exemptions for financial hardships, incarcerated persons, religious objections, and undocumented immigrants. Mandatory health insurance is important, and should be applied in all states because, everyone gets ill and at one time, they have to visit a health care facility for medical services. In addition, it protects the health future of families, and protects people from unexpected high medical costs because they are covered.
In the USA, health insurance is commonly included in employer benefit packages and seen as an employment perk.
Reforming health care system has been a hot topic for many years. A society's commitment to health care reflects some of it's most basic values about what it is to be a member of the human community (Cockerham, 2012). Legislators have been proposing diferrent policies in an effort to solve this dilemma without significant progress. All proposals to expand insurance coverage have had certain flaws and were sometimes far from being ideal or even realistic.
In terms of access, everyone is required to buy and maintain health care within the first 3 months of living within the country. If one cannot afford insurance, the government subsidizes for low-income families. This is extremely important to make sure everyone has health care. Access again is obtained based on what canton on...
As I started my Health Insurance class my belief was that this class will be pretty easy as I am familiar with much of the medical field. Personally having multiple illness’s and having three special needs children, personally I have learned so much within the medical field. However, as I began reading Chapters 1-3 in my Understanding Health Insurance book, the realization hit that I was not as knowledgeable as I thought I was. Therefore, I am eager and excited to learn new things in the medical field.